司美格鲁肽注射液治疗不同体质量指数2型糖尿病对糖脂代谢和脂肪因子的影响

doi:10.3969/j.issn.1006-5725.2025.09.018

Abstract

Abstract:

Objective To investigate the effects of Semaglutide injection on glycolipid metabolism and adipokine levels in the treatment of type 2 diabetes mellitus （T2DM） patients with varying body mass index （BMI）. Methods A total of 143 patients with T2DM admitted to our hospital between May 2022 and May 2024 were enrolled in this study. Based on their BMI， the patients were categorized into three groups： the normal-weight group （31 cases， 18.5 kg/m² ≤ BMI < 24 kg/m²）， the super-recombinant group （49 cases， 24 kg/m² ≤ BMI < 28 kg/m²）， and the obese group （63 cases， 28 kg/m² ≤ BMI）. 28 kg/m² ≤ BMI）. All participants received standard guideline-based conventional treatment and were additionally administered semaglutide injections for a duration of 12 weeks. The study compared glucose metabolism， islet β-cell function， lipid metabolism， body composition， adipokine levels before treatment and at 12 weeks post-treatment， as well as safety profiles during the treatment period across the three groups. Results After 12 weeks of treatment， the levels of fasting blood glucose （FPG）， 2-hour postprandial blood glucose （2 h PG）， glycated hemoglobin （HbA1c）， insulin resistance index （HOMA-IR）， serum triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） decreased in all three groups. Specifically， the reductions were more pronounced in the obesity group compared to the normal group and the super-reorganization group， and the super-reorganization group showed intermediate reductions between the obesity and normal groups （P < 0.05）. Conversely， fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 h CP）， irisin， adipsin， and omentin-1 levels increased in all three groups after treatment， with the greatest increases observed in the obesity group， followed by the super-reorganization group， both of which were significantly higher than the normal group （P < 0.05）. Additionally， high-density lipoprotein cholesterol （HDL-C） levels increased in all three groups after 12 weeks of treatment （P < 0.05）. BaselineBMI and total body fat mass （WBFM） were significantly higher in the obesity group compared to the super-reorganization group， which in turn were higher than the normal group （P < 0.05）. After treatment， BMI and WBFM decreased in both the obesity and super-reorganization groups， but remained significantly higher than in the normal group （P < 0.05）. The incidence of adverse reactions during treatment was 12.90% （4/31）， 10.20% （5/49）， and 11.11% （7/63） in the normal， super-reorganization， and obesity groups， respectively， with no statistically significant differences among the groups （P > 0.05）. Conclusion Smiglutide injection can improve glucose and lipid metabolism， islet function， and adipokine levels in T2DM patients across different BMI categories， while also regulating body composition. It demonstrates a particularly strong improvement effect on glucose and lipid metabolism， islet function， and adipokine levels in overweight and obese T2DM patients. Additionally， smiglutide does not increase safety risks.

Key words: type 2 diabetes mellitus, semaglutide injection, body mass index, glycolipid metabolism, lipofactor, body composition

CLC Number:

R587.1

Mingmei MA,Xiaochun MA,Shenghua MA,Yijin LI,Guifang JI. Effect of semaglutide injection on glycolipid metabolism and adipokine in the treatment of type 2 diabetes mellitus with different body mass index[J]. The Journal of Practical Medicine, 2025, 41(9): 1394-1400.

Figures/Tables 7

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References 27

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组别	例数	年龄（x ± s）/岁	性别/［例（%）］		T2DM病程（x ± s）/年	吸烟/［例（%）］	饮酒/［例（%）］
组别	例数	年龄（x ± s）/岁	男	女	T2DM病程（x ± s）/年	吸烟/［例（%）］	饮酒/［例（%）］
正常组	31	55.89 ± 5.72	17（54.84）	14（45.16）	11.88 ± 2.31	7（22.58）	5（16.13）
超重组	49	56.11 ± 5.05	26（53.06）	23（46.94）	11.73 ± 2.22	11（22.45）	8（16.33）
肥胖组	63	55.75 ± 5.43	39（61.90）	24（38.10）	12.01 ± 2.42	16（25.40）	11（17.46）
F/χ ² 值		0.062	0.983		0.199	0.163	0.037
P值		0.940	0.612		0.820	0.922	0.981

时间	组别	例数	FPG/（mmol/L）	2hPG/（mmol/L）	HbA1c/%
治疗前	正常组	31	8.41 ± 1.42	13.94 ± 1.19	8.14 ± 1.19
	超重组	49	8.63 ± 1.28	14.11 ± 1.15	8.09 ± 1.25
	肥胖组	63	8.71 ± 1.34	14.15 ± 1.52	8.21 ± 1.11
	F值		0.526	0.265	0.146
	P值		0.592	0.768	0.864
治疗12周后	正常组	31	7.46 ± 0.35^?	8.41 ± 0.54^?	7.01 ± 0.24^?
	超重组	49	7.29 ± 0.46^?#	8.07 ± 0.51^?#	6.87 ± 0.38^?#
	肥胖组	63	6.80 ± 0.48^?#&	7.20 ± 0.58^?#&	6.64 ± 0.33^?#&
	F值		28.480	62.472	14.625
	P值		< 0.001	< 0.001	< 0.001

时间	组别	例数	HOMA-IR	FCP/（ng/mL）	2 h CP/（ng/mL）
治疗前	正常组	31	3.41 ± 0.51	1.56 ± 0.41	5.14 ± 1.05
	超重组	49	3.45 ± 0.57	1.55 ± 0.42	5.08 ± 1.02
	肥胖组	63	3.51 ± 0.47	1.48 ± 0.43	4.92 ± 1.11
	F值		0.436	0.544	0.550
	P值		0.647	0.581	0.578
治疗12周后	正常组	31	2.67 ± 0.26^?	3.82 ± 0.56^?	9.11 ± 0.77^?
	超重组	49	2.42 ± 0.39^?#	4.32 ± 0.44^?#	9.86 ± 0.86^?#
	肥胖组	63	2.03 ± 0.35^?#&	5.04 ± 0.63^?#&	11.80 ± 0.81^?#&
	F值		39.465	55.236	138.596
	P值		< 0.001	< 0.001	< 0.001

时间	组别	例数	TG	HDL-C	TC	LDL-C
治疗前	正常组	31	3.06 ± 0.87	1.16 ± 0.32	5.49 ± 0.45	4.50 ± 0.81
	超重组	49	3.10 ± 0.85	1.14 ± 0.34	5.54 ± 0.86	4.52 ± 0.83
	肥胖组	63	3.18 ± 0.82	1.11 ± 0.32	5.43 ± 0.23	4.63 ± 0.82
	F值		0.249	0.270	0.526	0.368
	P值		0.780	0.763	0.592	0.693
治疗12周后	正常组	31	2.75 ± 0.21^?	1.33 ± 0.33^?	4.92 ± 0.35^?	4.01 ± 0.44^?
	超重组	49	2.53 ± 0.25^?#	1.36 ± 0.36^?	4.54 ± 0.31^?#	3.90 ± 0.41^?#
	肥胖组	63	2.17 ± 0.26^?#&	1.40 ± 0.34^?	4.14 ± 0.33^?#&	3.55 ± 0.42^?#
	F值		65.001	0.467	61.889	15.975
	P值		< 0.001	0.628	< 0.001	< 0.001

时间	组别	例数	BMI/（kg/m²）	WBFM/kg	FFM/kg
治疗前	正常组	31	22.02 ± 1.73	16.85 ± 1.77	58.84 ± 3.86
	超重组	49	27.17 ± 1.71^#	19.09 ± 1.62^#	58.02 ± 3.60
	肥胖组	63	31.87 ± 1.60^#&	22.11 ± 1.72^#&	59.20 ± 3.71
	F值		375.084	108.988	1.419
	P值		< 0.001	< 0.001	0.245
治疗12周后	正常组	31	21.98 ± 1.61	16.66 ± 1.41	59.05 ± 3.41
	超重组	49	25.65 ± 1.67^?#	18.92 ± 1.52^?#	59.20 ± 3.58
	肥胖组	63	29.28 ± 1.85^?#&	19.73 ± 1.44^?#&	59.25 ± 3.06
	F值		190.817	46.136	0.038
	P值		< 0.001	< 0.001	0.963

Effect of semaglutide injection on glycolipid metabolism and adipokine in the treatment of type 2 diabetes mellitus with different body mass index

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时间	组别	例数	irisin	adipsin	omentin-1
治疗前	正常组	31	4.56 ± 0.76	3247.86 ± 361.85	52.09 ± 3.20
	超重组	49	4.52 ± 0.87	3224.71 ± 389.72	51.82 ± 3.21
	肥胖组	63	4.46 ± 0.84	3192.46 ± 378.13	51.44 ± 3.05
	F值		0.166	0.244	0.491
	P值		0.847	0.784	0.613
治疗12周后	正常组	31	4.96 ± 0.65^?	4729.97 ± 513.31^?	57.80 ± 4.14^?
	超重组	49	5.33 ± 0.66^?#	5145.11 ± 455.24^?#	63.13 ± 4.43^?#
	肥胖组	63	5.80 ± 0.71^?#&	5676.06 ± 421.22^?#&	67.10 ± 4.11^?#&
	F值		17.122	48.864	50.979
	P值		< 0.001	< 0.001	< 0.001

组别	例数	恶心呕吐	腹泻	便秘	轻度低血糖	合计
正常组	31	1（3.23）	1（3.23）	0（0.00）	2（6.45）	4（12.90）
超重组	49	2（4.08）	1（2.04）	2（4.08）	0（0.00）	5（10.20）
肥胖组	63	2（3.17）	2（3.17）	3（4.76）	0（0.00）	7（11.11）
χ² 值						0.140
P值						0.932

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